DIRECT PAYMENT REQUEST FORM

 Rev. 7/25/16

Use this form to request payment for expenditures not processed in STARS or paid by a PCard. Use the Expense Report for travel related expenses. For wire transfers, use the Wire Transfer Request.

Note: If vendor is not in Banner, attach the New Vendor Registration Form and W-9 or W-8BEN completed by vendor.

Banner Vendor ID: _________________________ Search vendors in Banner AP address sequence #: _______

Payable to (vendor name): _______________________________ Special handling: (optional) Remit to Address: _______________________________ Call ______________@_____

_______________________________ Send to dept ______________ _______________________________ Send to WPI box# _________ _______________________________ Mail with enclosure

Description Invoice # Invoice Date Invoice Amount

Total: Attach invoices or documentation

Fund Org Account Activity (optional) Amount

Total:

Authorization: Financial Manager Approval: ______________________________________ Campus Ext.:______________________

Type or print

Signature: _______________________________________________________ Date: __________________________

Print and send to Accounts Payable, Boynton Hall.

Please allow 7–10 days after submission to Accounts Payable for processing. Incomplete or inaccurate requests may delay processing.

For Accounting use only: 1099 Y / N

Finance Office approval: _____________________________________ Date: _______________________________